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What Does High Level Of Protein In Urine After Pregnancy Indicate?

Posted on Thu, 25 Jun 2015

Question: This is a follow-up question with new reports. Previous case history is given below.

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My Wife (XXXX) had very high level of protein during both of the pregnancies. She had undergone quarterly review with a nephrologist after pregnancy and protein level is still high but doctor suggested we can ignore this for now as its not alarming and advised to reduce weight and that will bring the protein level down. As of now we are not monitoring it. So I need the second opinion on this case from a specialist. The question I have primarily are

1. is this level of high protein always even after pregnancy is OK?

2. what we should do to fix this? we are working on weight but that is not coming down as of now probably need more effort. is there any medication needed?

3. what are the risks having this level on daily basis?

4. do we need to monitor this periodically? if yes how frequently?

Thanks,
XXXX

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Need more info

Detailed Answer:
Hello

Thanks for getting back with the 24 hour urine protein.

I see that 24 hour urine protein is slightly on the higher side. I need to know a few more details in order to help you

1. Was her BP and sugars checked anytime recently?
2. Did she have hypertension during pregnancy along with protein loss?
3. Does she exercise?
4. What is her height and weight?

I will answer all your questions but the answers depend on what you get back to me with,

Awaiting your reply

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (5 minutes later)

Thanks Doctor for quick reply. Please find answers below.

1. Was her BP and sugars checked anytime recently?
[Answer]: Yes, it was done multiple time and sugar and BP was normal. Last it was done in XXXXXXX 2015.
2. Did she have hypertension during pregnancy along with protein loss?
[Answer]: Yes. But BP is normal now.
3. Does she exercise?
[Answer]: No. Not possible now a days along with two children.
4. What is her height and weight?
[Answer]: Height: 5 fit 4 inches Weight: 107 KG

Answered by Dr. Rakesh Madhyastha (9 minutes later)

Brief Answer:
Protein loss

Detailed Answer:
Hello

Its a relatively free day for me today, I came back early from the hospital to relax as last week was full of transplants and procedures

Here are my recommendations

Her small amount of protein loss is because she is over weight. It is essential that she loses weight. Her ideal body weight for her height is 67 kgs

Now let me answer your questions one by one so that I dont miss any

1. This level of protein loss is not normal after pregnancy. There should not be any protein loss after pregnancy

2. I recommend you to start on Tab Telmesartan 40 mg once a day. It will bring down the protein loss and also has beneficial effects on the kidneys as it is a reno protective agent. ( This is a suggestion not a prescription)I also suggest you to get professional help to lose weight. Losing 30 kilos definitely requires professional assistance as it is not easy

3. Protein loss is toxic to the kidneys, it slowly progresses into chronic kidney disease.

4. I monitor protein loss every once in 6 months. Some of my XXXXXXX faculty do it once a year

I hope I was of help, please get back to me for any further queries

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (6 minutes later)

Thanks doctor for such detailed reply. This help.

It looks like there is no immediate need to go for renal biopsy as you suggested earlier and first she should completely focus on weight loss with professional help and then monitor protein level.

Tab Telmesartan 40 mg once a day how long does she had to take?

Answered by Dr. Rakesh Madhyastha (0 minute later)

Brief Answer:
Ace/arb

Detailed Answer:
Hello

Thanks for getting back

There is no need to get a biopsy done. Telmesartan should be continued indefinitely, it has a lot of beneficial effects. next time you approach your doctor you can enquire about this suggestion.

Regards

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar